If you are Tested and Find Out You Have High-risk HPV, What Does That Mean? What Happens Next?

What are the different types of Pap test results?

A

If you’re younger than 30, experts say that the only type of routine cervical cancer screening you need is a yearly Pap test. When your Pap is read by the lab, it is classified as one of the following:

Normal. No further testing is needed until your next annual exam.

Inconclusive, borderline or – in medical terminology – “ASC-US” (atypical squamous cells of undetermined significance). Simply put, this means the cells don’t look clearly abnormal, but they don’t look clearly normal either. An HPV test (which the lab can usually do on the same sample of cells used for the Pap) is needed to determine if a high-risk type of the virus is present. If so, a colposcopy procedure is usually needed to allow your doctor or nurse to examine your cervix for pre-cancerous cells that need to be removed. For girls under 20, HPV testing is not recommended, even in this situation. For further explanation, click here.

Abnormal. In this case, your doctor or nurse will do a colposcopy procedure to further examine your cervix and determine whether any pre-cancerous cells are present that need to be removed. A biopsy – in which a portion of tissue is removed for analysis in the lab – may be performed at the same time.

Q

What does it mean if your Pap is inconclusive and an HPV test shows you also have a high-risk type of the virus?

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First, remember: You are not alone. It is very common to have HPV. In addition, having a high-risk type of the virus does not automatically mean you have or will develop cervical disease or cancer. It's estimated that women who have an initial inconclusive Pap and HPV have just a 15-27 percent risk of being diagnosed with moderate to severe (pre-cancerous) cervical disease.

The next step is for your doctor or nurse to perform another exam called a "colposcopy" that allows a closer look at your cervix. If any abnormalities are visible, a biopsy should be done as well, in which a sample of tissue is removed and examined by the lab. Mild cell changes will likely be monitored for a while, since most go away on their own – without causing any problems – within one or two years. If moderate to severe abnormalities (CIN 2 or 3, also called pre-cancer) are found, treatment is needed to remove the cells.